Transitioning to oral feeding: A retrospective cohort study of a family‐centered, hunger‐based tube weaning program
Bibliographic record
Abstract
BACKGROUND: We investigated the effectiveness of a novel, hunger-based outpatient tube weaning program for children with feeding-tube dependency. METHODS: This interdisciplinary program induced hunger via rapid reduction in tube-fed calories, followed by 2 weeks of daily outpatient mealtime support and regular follow-up. Forty-one children (6.9 months to 12.8 years) participated in this retrospective cohort study. RESULTS: Before the program, children received a median of 90.0% (interquartile range [IQR]: 75.0%-100%) of caloric intake via tube feeds. At the end of the 2-week program, children received 16.0% (IQR: 0.0%-30.0%) of caloric intake via tube feeds, which further reduced to 1.5% (IQR: 0.0%-33.0%) at 6-months, and 0.0% (IQR: 0.0%-35.0%) at 1-year follow-up. The percentage of participants who ate >30 different foods increased from 4.9% at baseline to 81.5% at 1-year follow-up. The baseline median weight z score of -1.24 (IQR: -1.69 to -0.69) decreased to -1.81 (IQR: -2.77 to -1.02) at 1-year follow-up. A linear mixed-effects model demonstrated that weight z score was significantly higher at baseline and 2-weeks compared to the 1-year follow-up (P < 0.001 and P = 0.001, respectively), but was not significantly different between 6 months and 1 year (P = 0.44). Age was not associated with percentage of caloric intake via tube feeds or number of foods eaten. CONCLUSION: Children who participated in the hunger-based tube-weaning program had increased and more varied oral intake 1 year following the intervention. The median weight z score decreased over the year after intervention but did not significantly decrease between 6 and 12 months after the program.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".